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Efficacy of Tranexamic Acid on Myomectomy-Associated Blood Loss in Patients With Multiple Myomas: A Randomized Controlled Clinical Trial

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Abstract

Objective

To evaluate the efficacy of tranexamic acid (TA) in decreasing blood loss during and after open myomectomy for patients with 3 or more uterine fibroids.

Methods

This prospective randomized trial was conducted among 132 women subjected to abdominal myomectomy. Patients were equally divided into 2 groups by simple randomization. The study group received perioperative intravenous TA while the control group did not. Intraoperative blood loss was calculated by measuring the volume in the suction apparatus and weighing the surgical swabs in addition to postoperative blood loss collected via a suction drain. Hemoglobin and hematocrit values were determined preoperatively and on the third postoperative day for all cases. Any adverse effects were recorded in both groups.

Results

No significant difference was found between the two groups regarding age, body mass index, number, and size of myomas removed. The TA group showed lower amount of blood loss (407 mL) when compared to control group (677 mL; P < .01). Risk estimation has revealed that treatment with TA resulted in decrease in risk of perioperative blood loss by 40%. In the study group, 13 (19.7%) patients required blood transfusion in contrast to 23 (34.8%) patients in the control group (P < .01). Hemoglobin and hematocrit levels were significantly lower in the control group on the third postoperative day (P value = .001) .

Conclusion

The TA reduces blood loss during and after myomectomy for patients with multiple uterine fibroids.

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Authors and Affiliations

  1. Obstetrics and Gynecology Department, Faculty of Medicine, Suez Canal University, Round Road, 41111, Ismaili, Egypt

    Mohamed M. Shaaban MD, Magdy R. Ahmed MD, Rasha E. Farhan MD & Hanaa H. Dardeer MSc

Authors
  1. Mohamed M. Shaaban MD
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  2. Magdy R. Ahmed MD
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  3. Rasha E. Farhan MD
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  4. Hanaa H. Dardeer MSc
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Correspondence to Magdy R. Ahmed MD.

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Shaaban, M.M., Ahmed, M.R., Farhan, R.E. et al. Efficacy of Tranexamic Acid on Myomectomy-Associated Blood Loss in Patients With Multiple Myomas: A Randomized Controlled Clinical Trial. Reprod. Sci. 23, 908–912 (2016). https://doi.org/10.1177/1933719115623646

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  • DOI: https://doi.org/10.1177/1933719115623646

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